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Fallguy

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  1. Fallguy

    Eviction notice

    Yes, it was exhausted in August. I’m lucky to still have a roof over my head so I know the landlord has gone beyond his limit and understanding my situation. The adjuster knows that I don’t have any income so they want to do everything they can to get me to settle before the report comes out.
  2. Fallguy

    Eviction notice

    I was injured on the job over a year ago. I had state Disability But that was exhausted in August. Since then, I have been desperately fighting workers comp to get my benefits but they have gone to great lengths to delay and avoid it. I just seen my second qualified medical evaluator and he won’t allow me to do any work until he’s sees the mri. The landlord has been really helpful the last year since I’ve been late every single month due to sdi employees that spends more time to lie to claimants instead of processing benefits. I’ve applied for ssdi but workers compensation seems to have already tried to paint me as a fraud. Pretty much like everyone else. I haven’t paid November rent and December rent is due soon. I sent the landlord an email last week that the judge wants to see the qme’s report before he makes a ruling. I’m expecting the report any day now but my hearing isn’t until late December. I told the landlord that I can pay all the late fees and all the rent due once I receive the loss wages benefits. At the very least, the carrier still wants to settle for 10k. I panic when I say a red tag on my door. I don’t know what an eviction notice looks like but it was just my water getting shut off. I’m still expecting the eviction notice any day because the landlord hasn’t replied. If I do receive it, how much time do I have to move. I don’t have any family here so I don’t know where I can store what left that I own. I thought about selling my car but it’s not worht anything. My credit dropped the last year because I couldn’t make the credit card payments. I had just paid $8,000 right before my injury to get my credit in good standings and approved for the lowest credit card possible. I’ve tried United way and Salvation Army but no assistance. Any advice will appreciate and thank you in advance
  3. Fallguy

    Eviction notice

    I just receive my eviction notice. I have received the 3 day notice every month for the last 5 months. I have not had any income since August and the new doctor does not want me to work until he reviews my mri. I havnt worked in two years and fell behind bills trying to adjust to 55% of income the last year. Any suggestions other then pay the rent would greatly be appreciated.
  4. Fallguy

    Accepted claim

    Sounds fair enough. I’ll break it down to important events so hopefully you can make some sense out of this mess. I would really be thankful and my mind could use a break. i will used estimate dates so there’s no confusion: 1-1-17-doi slip on wet floor. The manager reported it to HR, I went to ER, I was out a about 7-8 days 1-10-17- went to doctor from list that was provided. Dr reports as industrial and modified work. 1-13-17- went to work to show dr note. I was terminated for misconduct that was from 12-1-16. 1-21-17- received denial for no witness or medical evidence. Also states that my injury is Not covered by LC 3208.3. They don’t good faith personal injury. 6-1-17- qme- reports industrial and modified duty- and mri. 8-1-17-mri appointment 2-1-18- supplement report says nothing’s change and mmi date is 8-1-17. He retires and haven’t heard from him since. sdi was effective 1-10-17 ptp- has ttd since doi last week, I went to hearing for ttd. Judge couldn’t decide so wait for results of qme appointment. I overheard their attorney tell the judge that my claim is accepted. I received Acceptance letter. 3 days later, received denial again. Says we accept dr report of dates and ttd but ttd denied for termination of caused. Next qme appointment is next week the dates are not exact and I left out all the crazy things the adjuster did in between. Hope this helps
  5. Fallguy

    Accepted claim

    I couldn’t resist an opportunity to hear ElleMD expert opinion so I have to ask. If ElleMD or anyone else who can explain how the adjuster can deny a claim without any legal or medical evidence to support the denial? They can also misused labor codes to deny your claim. (They can conveniently say they were over work and mixed up their work.) There is no entity or remedy for the injured worker other than an anonymous complaint through the wcab audit referral form. You will know if they were sanctioned. Why is it that attorneys, physicians, judges and adjusters can all use “I didn’t have all the information” to excused their actions? I will agree with your statement that I have no idea what I am doing but everything else are just assumptions. Although rare, you can’t definitively say it has never happened before. Had it not been for my sales acumen, I would have taken their first nuisances offer. That offer increased three times within a week without a counter offer. You really need sales experience to know the basics but I became curious to know why the desperation and need settle so quickly. The very last offer included open medical and I decline because they have never once explained why or how they calculated the settlement amount. Some will say it’s paranoia but I call it “extra cautious”. I wouldn’t be in this position had I been cautious instead of trusting the WC system. Here’s a little more facts I’ll share. The carrier does not have a standard procedure to notify their claimant that their claim has been accepted. All the while, they continued to deny benefits, hire private investigators for surveillance and strong arming you to take the settlement. This is direct statement from the assistant chief of claims. I went to three level of management and everyone gave me a different answer to date that my claim was accepted. Two of them is still in denial and sticking to no benefits because I was terminated from my job. The bottom line is, if you get injured and if the IC decides to make an example out of you. They will have an open book to ensure you are screwed. I’m sure they have in house counsel and possibly private investigator but one would think that would be a conflict of interest. I’m sure the investigation cost more then the settlement offer. I can say this because I’ve seen the video. The odds of the PI being at the right place at the right time is very small. Let me add that I asked the adjuster and his manager several time if he made an error and cited the wrong labor code. He said if I’m not happy then I can take it to wcab. I’m sure it’s not the first time he fraudulent denied a claim. Otherwise he wouldn’t be as bold. There’s is no end to this unless I walk away. Any awards would have to be approved by the judge so im sure there’s never going to be any penalties. The carrier can delay until their account is empty. They have change counsel, already sabatoge the second qme appointment. That means they’ve already prepared for the third panel or they know the judge will allow non medical records that I never received and sent well beyond 20 days of the appointment. I didn’t even get a chance to review those records. ElleMd, if you can explain why the carrier can deny a claim for any reason they choose without any justification, I will recant my statement of corruption in the WC system.
  6. Fallguy

    Accepted claim

    I would like to give details but it wouldn’t change much. I don’t know if you will be willing to give me any feedback. I do believe that you would know what steps I need to take so the carrier doesn’t delay any further. My case is at the stage that the only thing the carrier can do now is delay benefits. It’s not that I can’t find representation. I’m sure someone will take it but I’ve decided that I will not use anyone that has ties to the carrier. I want an attorney who will fight for injured workers. I’ve seen enough to know that there are many types of attorneys. Some just goes with the flow and accepts more cases than they can handle because more cases equal more money. Then there are those that really look into the details of the case and actually applies laws to help the injured workers. California may be a claimant friendly state but carriers and lawyers are 99.9% protected. All complaints against carriers goes through the audit process and its anonymous so you will never know if they were disciplined. All complaints for attorney goes through calbar and there’s a simple excuse they can use to avoid any malpractice. I forgot the term for it. I havnt done too bad by myself and to debunk the theory that my case is only worth $500. I can tell you that they have offered future medical and open medical if I want to settle. They also offered to settle with ppd and I turned down all three. I don’t know much about the value of my claim but I have sales experience so I understand the negotiation process. I decline simply on the fact that they made those offer too easily. I’m curious to know the true value. If they are willing to hire an attorney and do a year of surveillance, there is something more than meets the eye. All this for a “fall”? How did a simple fall turn into using so much of the carriers money to deny a claim that was accepted? I really need your expertises ElleMd. Have you ever seen anything like this?
  7. Fallguy

    Goodbye

    Thanks everyone. Although I didn’t get much help here and accused often, it kept me going. I no longer need to stress over the adjusters silly games. I finally got the answer I’ve been searching for. I think I made it harder than it should have been. I realize workers compensation laws has a simple process to follow. The only time things get murky is when your employer terminates you. The end game is that the truth will eventually be reveal if you understand the tactics that the adjusters uses. I might have to write a book about my experience with workers comp. it sounds like there a lot of attorneys on here so I apologize if I offended anyone. Thanks everybody who has help me. Yes, even you payrollguy. I wish I would have gotten to learn more from ellemd.
  8. Fallguy

    Accepted claim

    Thats pretty funny.....you can come up with something better than that. You haven’t provided any context to support your statements. If that makes you feel better, I guess you can say whatever you want. I’m not the expert here so I doubt anyone would care about my character.
  9. Fallguy

    Accepted claim

    Have you tried calling recently? I can assure you that the calls are being answered by the attorneys assistant. They all screen the call in similar order. You would have a better chance winning the lottery than speaking to the attorney. They write down name and info, then they look up your case in the system. After that, if it’s something they choose to take, you will get a return call. Now if you are somehow lucky enough to get an assistant who’s aggressive in setting appointments, you will get an appointment. The appointment will not be with the attorney, it will be with the assistant. Sometimes, they will call you before your appointment and cancel because the attorney recognizes your case and doesn’t want to bother. payrollguy, is this standard practice or did I imagine this? Trust me, I called so many that I could probably get a job setting appointments.
  10. Fallguy

    Accepted claim

    There are quite a few so I’m sure someone will. The problem is finding who is who. If they’re st the bottom of totem pole, you be lucky to get a nuisances settlement. The ones that decline my case are usually the names that pops up when you google workers comp attorney. I read somewhere that attorneys are far to busy to tend to every client. This is not true, at least in my city. I’m sure everyone is in each other’s contact list.
  11. Fallguy

    Accepted claim

    Its not gonna happen. I stumble into the hub of workers comp attorney and most them are in bed with the carrier. My only chance is an out of state attorney
  12. Fallguy

    Accepted claim

    I’m back with one last question that will make a big impact on my claim. This question is regarding my workers comp claim in California. Here is a quick overview. I slip on a wet floor in the break room and I was terminated the day the doctor release me on light duty. I was never offer any light duty work. The reason was for misconduct for something that happen over a month before date of injury. My claim was denied completely. I am now being told that my claim has been accepted but I’m not entitled to ttd because I collected sdi and I was already compensated. I was told that if they paid me ttd then I would have collected twice for same span. My argument was that I should be entitled to the difference since sdi paid at a lower amount and they use income from a different date. They said it’s not correct but there are times that they have paid the difference if the injured workers wants to settle. This case from a person who is supposed to be neutral. Why would a neutral person try to convince me to take a nuisance settlement. It sounds like the carrier wants to avoid the lein by getting me to agree. Ellmd? Payroll guy... I need some assistance
  13. That doesn’t mean that I don’t either. Maybe you can enlighten me as to why a person without a case would spend valuable time to look for advice on a forum full of strangers? What are the pros and cons? I’m sure you’ve encountered your fair share of people trying to commit fraud but part of my questions or answers swayed you from answering any of my questions? I know you have control of which topic you want to reply to so if you truly feel I don’t have a case, you certainly have a choice to not reply. Once again, I apologize if I said something that didn’t sit well with you but I have to win this one for all the injured workers who’s been denied without any valid reasons other than the law allows the carrier to do so. Im sure I was chosen because my employer decided to cut losses and it’s the carrier decided to join because two against won is favorable odds to take a chance on. I was fortunate enough that these forums has provided just enough that I may be able to get treatment for my injury.
  14. These are all true statements except the part about the doctor denial. I don’t any doctor can deny a claim. I’m sure they can say the injury didn’t happen during work but if that was the case then I wouldn’t be wasting my time or anyone else’s time. I did say that I’m not interested in getting more money but I never said that I didn’t want to replace what I’ve lost. i would not be on a forum asking questions if I had any attorney. I have been turned down on many occasions. I even reached outside of my town and i had three attorney say no. if I am breaking any rules by asking too many questions, please advise. I’m sure most are frustrated because it’s confusing and I’ve apologize many times for that. Being confused and frustrated is one thing but making assumptions or accusations about ones character is another.
  15. Would you mind providing some context?
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